Vice President Mike Pence arrived on the Senate floor Thursday to cast a tie-breaking procedural vote that would forward legislation designed to roll back the Obama-era Title X rule and permit states to deny funding to Planned Parenthood.

Just before leaving office, former President Barack Obama “cemented his legacy as a champion of women’s health,” according to Planned Parenthood president Cecile Richards, when he signed legislation designed to protect a key part of the organization’s funding. In a last move to safeguard the provision of women’s health care, the administration finalized a rule on the Title X program prohibiting states from withholding program funding from Planned Parenthood for political reasons. The amendment stipulated that only under circumstances in which a provider was unable to deliver family planning services could its funding be withdrawn. Pence’s tie-breaking vote on Thursday advances the GOP effort to undo Obama’s protections.

The vote had been held open for more than an hour in a 50-50 tie, deadlocked after Republican Senator Johnny Isakson of Georgia, who is recovering from back surgery and hasn’t voted since February 17, was summoned to the Senate to vote in favor of the legislation.

As Republicans waited for Isakson to arrive in the chamber, Senate minority leader Chuck Schumer’s office issued a statement to reporters with the subject line: “What’s going on with this Senate vote? The VP needs to break the tie & harm women’s health.” Meanwhile, Senator Mazie Hirono of Hawaii tweeted, “Just in case we didn’t already have enough men making decisions on women’s health.”

.@VP is on his way to break a tie on #TitleX funding. Just in case we didn't already have enough men making decisions on women's health

Two GOP lawmakers joined all of the Democrats in opposing the measure — Senators Susan Collins of Maine and Lisa Murkowski of Alaska — both of whom have long resisted their party’s efforts to defund the women’s health care provider.

Introduced under President Richard Nixon’s administration in 1970, the Title X program subsidizes preventive health care and family planning services for four million low-income Americans, typically those with an annual income below $23,500. Planned Parenthood serves around one-third of them. But, perhaps no more. A final vote on repealing the Obama-era legislation would put at risk the provision of women’s health care linked to contraception, fertility, pregnancy care, and cervical cancer. Nonetheless, defending the measure, Senate Majority Leader Mitch McConnell referred to the Title X rule as an “unnecessary restriction on states that know their residents a lot better than the federal government” and said it hurt “local communities”.

The vote takes place during the same week that a group of anti-abortion activists, who created a series of under-cover sting videos of Planned Parenthood, were handed 15 felony charges in an arrest warrant. Republicans in Congress often referred to the activists’ false claims — that the tapes showed abortion providers “selling” fetal tissues acquired during the procedure — to justify a 15-month-long congressional investigation into Planned Parenthood.

David Daleiden and Sandra Merritt, the two activists behind the recordings, were charged with “15 felony counts of violating the privacy of health-care providers by recording confidential information without their consent.” The U.S. Ninth Circuit Court of Appeals later granted the National Abortion Federation a preliminary injunction banning Daleiden from distributing anymore of the illegally acquired recordings.